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Noticed pea sized grain bottom of testicle. Ultrasound shows cyst. Found lower abdominal pain. What can be done?

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Addiction Medicine Specialist
Practicing since : 2002
Answered : 1486 Questions
Dear dr,

I have an issue which caused me great anxiety, fear n trouble 24/7.

I had a pea size grain at the bottom of my left testicle about 10 years ago. 3 years ago , I decided that I should have it checked. Ultrasound shows that was a cyst. 2.5mm. The dr assured me that it's fine n leave it alone. Rest my heart n went on my busy work life again

One month ago , I had some lower abdomen pain that seemed to make my testicle hurt when I passed motion. Check on my testicle, found a m&m size lump on my left testicle, this time sitting on top of the left n bigger than the one below it. My anxiety XXXXXXX to the XXXXXXX n I flew 4 hrs to get an ultrasound. The dr said it was a cyst n 8mm. He said it was a spermatocele n is benign .. I left the clinic, with things running in my head..

I googled n found my website or forums related to testicle cyst.. I'm afraid that it will grow slowly , n one day I need to aspirate it or surgical removed. I XXXXXXX wan that to happen . Especially at that very sensitive part of male organ ..

I wan to know why it i get them?? Now I have 2 cyst, when will the 3rd cyst come?? I'm so afraid n y I had to go thru these things..

I'm so prone to cyst, and the scariest thing saying that cyst growing had no scientific explanation as yet. I'm so afraid that it will become cancer . N usually , cancer Oso no real proof of explanation .

I had a submandibular gland tumor when I was 12, grew to a size of a golf ball at age 17, eventually got it removed, benign tumor phleomorphic adenoma. Then again I asked the dr, no real reasons... My so young then like "what have I done??!!" I'm so afraid to go thru surgery stuff.. I can't afford to go thru them again.. I so afraid of growths in my body ... N there seemed no way to prevent them.

I'm very "aware" of my testicle now. When I sit, eat , sleep , talk etc. I will go to the toilet now n then to keep checking on my nuts.. I can't stop thinking of them !!!
I begin to walk in such a way that I XXXXXXX hurt my testicle n afraid to stand straight, which eventually gives me strain pain on my thighs..

I keep checking them , when I XXXXXXX check them , I will tell myself to check them again "later"

My anxiety is high n I felt so depressed.. I XXXXXXX know if that's a urology issue or becoming a psychiatrist issue..

Pls advise
Posted Sun, 4 Aug 2013 in Smoking and Alcohol Addiction
Answered by Dr. Preeti Parakh 7 days later

I understand you are worried about the cysts and are scared that it may turn malignant. I would like you to know a few things about these cysts. Firstly, spermatoceles are common, with upto 30% of all men having one or more. Secondly, they are harmless, being more of a nuisance rather than an illness. Thirdly, an increase in the size of a cyst is because of increase in the amount of fluid secreted by the lining of the cyst and not due to any cancerous process. I understand that you are afraid of surgery because of your prior experience when you were operated for the sub-mandibular gland tumour. But removal of a spermatocele is a far simpler and minor surgery. It is done on out-patient basis, usually with local anaesthesia and you are free to go home in an hour or so. Also there is no significant risk of any serious damage to your organ. In case you still do not wish to remove the cyst, even then there is no problem. You can choose to keep them all your life, with absolutely no issues. There is no particular reason why some people get them and some do not.

Now coming to your present symptoms of repeatedly checking your testicles, I would like to know a few things. Have you had similar problems of checking things again and again previously as well? If you are unable to check your testicles for some reason, do you feel unable to concentrate in your work till you go and check? If the answer to both these questions is in the affirmative, then I would like to assess you further from a psychiatric angle. Till then, I would like you to tell yourself that what you are having is nothing worse than having acne, or maybe even better! If this does not allay your anxiety and you still feel anxious and need to check your testicles repeatedly, please let me know.

Hope this has been helpful. Best wishes.

Dr Preeti Parakh

Above answer was peer-reviewed by
Follow-up: Noticed pea sized grain bottom of testicle. Ultrasound shows cyst. Found lower abdominal pain. What can be done? 53 minutes later
Dear dr ,

I would like to thank you for your clear reply. You are one good doctor who knows wat I'm going thru. It could be due to my past experience that I became like this. Yes u are very right, I can't get to concentrate on my work. I keep telling myself that something is not right "there" everytime I pass urine I will check, when I bathe ,when I chatted when I do work etc. I can't get it of my mind. N if I check on it, sometimes I feel that something isn't right, I will walk out of the toilet feeling down n depressed only to check on them again later on to feel safe..

Not alot Doctors understand this agony ... I know wat I'm doing is not right , but I can't help worrying 24/7. I even dreamt of a dr telling me that I might not be able to have kids in future last night..

I'm an anxiety disorder sufferer for 7 years. It all started 7 years back that I had blood on my pee n semen. The dr sent me for all the tests. It was infection eventually n cleared up with antibiotics . All the appointments Fr X-ray to scope, to prostrate check etc. the appt waiting n tests anticipation put me in high distress . I was in a very stress job n a high performer in work at that time. Ever since that, I had recurrent infection. Then I realized that it could be due to the fact that I always hold my urine cos I'm busy with clients n no time to pee. I changed the habit n things improved. I recovered from depression n eversince I had anxiety disorder n hypochondria.

Before the cyst thingy, I had pvcs. Wore a holder monitor n came out to be benign n dr say no need treatment . I took some Passion flower to calm down, it does help abit but til now I stil have them.

I got stomach flu, had straining bowels n pain on my lower abs after. I check on my testicle as the pain seemed to travel down there. There is when I found out the cyst thing ..

I know dr will say its psychological at this moment . I can't helped it. I wan to be happy like many out there. There is no one to truly understand my situation. Seeing the dr again will be the same thing.

Thks for reading me out. I would appreciate if u can share some of your experiences to help me. Many thks
Answered by Dr. Preeti Parakh 1 hour later

Thanks for explaining your history in detail. I am now better able to understand your problem. By now you must have realized that you tend to worry a lot about health problems which appear to others to be minor. You are right when you say you cannot help it and want to be happy like others. XXXXXXX you have hit the nail on the head when you say that you suffer from an anxiety disorder. But it seems you have never consulted a psychiatrist for the same. The good news for you is that symptoms like yours are amenable to treatment with medications like fluoxetine, sertraline etc. These medications can reduce your preoccupation with the illness, your anxiety and your desire to repetitively check your testicles.

Please consult a good psychiatrist and start medications under his/her care and supervision. In addition, try some relaxation exercises like deep breathing on a regular basis. I am sure you will find a remarkable difference in the quality of your life within a few months.

Best wishes.

Dr Preeti Parakh
Above answer was peer-reviewed by
Follow-up: Noticed pea sized grain bottom of testicle. Ultrasound shows cyst. Found lower abdominal pain. What can be done? 12 minutes later
Dear dr, I had seen a psychiatrist since 7 yrs ago. Took florxetine, seroxat ,etc. it hadn helped at all.
Answered by Dr. Preeti Parakh 14 minutes later

You mention that you had taken fluoxetine and paroxetine (seroxat) earlier and found no benefit. I am not sure whether you took an adequate dose for an adequate duration or not. Fluoxetine is started in the dose of 20 mg/day and gradually built up to 80 or 100 mg/day. It takes around four to six weeks to start acting and many times people discontinue it before that thinking that it is not working for them. You also would need to continue it for around a year or more after you improve. Paroxetine is a similar drug and the dose needs to be built up gradually. Sertraline and escitalopram are two other agents which can be tried if the previous ones have not benefitted you.

Please do not lose hope. Millions have benefited from these medications. There is no reason why you wouldn't.

Best wishes.

Dr Preeti Parakh
Above answer was peer-reviewed by
Follow-up: Noticed pea sized grain bottom of testicle. Ultrasound shows cyst. Found lower abdominal pain. What can be done? 1 hour later
Dear dr, I had enough of medication ... N I really XXXXXXX think that after taking the medicines that I will stop checking on myself or the cysts. Or rather alter these thoughts or behavior.

In the first place if there isn't any issues , y the worry?? And if there is issues, y are there always no reason to prevent ??

I only go to the clinic talk to the dr for 10-15mins. Pay few hundreds bucks n off with medicine everyday... I'm tired of all these. One issue come after another... When will it stop?
Answered by Dr. Preeti Parakh 1 hour later

It seems you are disheartened as well as disillusioned. People with symptoms far more severe than you, in fact so severe that they compulsively check for hours, have responded very well to medication. The medications that I discussed earlier are very safe and effective in changing both thoughts and behavior. You are right when you say that there is worry without any reason and this is why, it is indicative of a disorder of thought. In your case, after the repetitive urge to check, you are also compelled to check and you feel distressed if you avoid checking. I wish to reiterate again that this is a common illness that responds well to medication. If however you still do not wish to take medicines, there is one other option for you. Try resisting the impulse of checking. Initially it will be distressing, but if you persist, you will gradually see the distress reducing and finally you will experience no distress. This is based on the principles of behavior therapy and like medication, it also takes time to act but is a well researched and well known remedy. You can ask your psychiatrist to take you up for cognitive behavior therapy which is a short term psychotherapy targeted at changing the problem thoughts and behaviors. It is said to be as effective as medications.

You asked "When will it stop?". XXXXXXX it will not stop until the basic problem is resolved, which is a disorder of thought. Till then, every small ailment will appear as a serious disorder to you, causing you anxiety and excessive preoccupation with your health, lowering your productivity and output. So please do not give up. Consult a good psychiatrist and I am sure you will see a significant difference, like millions of other people.

I hope this has been of help. If there are no further queries, you can close the discussion and rate it. Best wishes for an anxiety-free life.

Dr Preeti Parakh

Above answer was peer-reviewed by
Follow-up: Noticed pea sized grain bottom of testicle. Ultrasound shows cyst. Found lower abdominal pain. What can be done? 1 hour later

Thk u for being so understanding. I absolutely understand where you are coming from. Seemed like I can only help myself.. Hopefully I will break free soon..
Answered by Dr. Preeti Parakh 2 hours later

Thank you for your kind words. Have faith in yourself and do not give up. I am sure you will soon be able to bring a positive change in your life.

Best wishes.

Dr Preeti Parakh
Above answer was peer-reviewed by
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